Please fill out the form below and we will get back to you within 24 hours. PERSONAL INFORMATION: Name: * First Name Last Name Address: * City/State/Zip: * Phone #: * (###) ### #### Email: * EMPLOYMENT DESIRED Position(s) applied for at new MASSILLON location (2010 Lincoln Way E, Massillon, OH): Crew Members - Massilon location Shift Managers - Massilon location Position(s) applied for at NORTH CANTON location (123 S. Main Street, North Canton, OH): * Cashier - North Canton location Cook - North Canton location Food Runner - North Canton location Expeditor - North Canton location Dishwasher - North Canton location Busser - North Canton location If you are under 21 years of age, please state your date of birth: (no one under age of 16 may be hired) MM DD YYYY Are you legally authorized to work in the United States? * Yes No WORK SCHEDULE AVAILABILTY What shifts will you work? * Weekly Availability / Day Time * Monday Tuesday Wednesday Thursday Friday Saturday Sunday Weekly Availability / Night Time Monday Tuesday Wednesday Thursday Friday Saturday Sunday How were you referred to Howlin Bird? EDUCATION/TRAINING High School Name & Location: Diploma: College/University Name & Location: Diploma/Degree: Subject: EMPLOYMENT HISTORY Company Name 1: Company City & State: Position: Dates From: Reason For Leaving: Supervisors Name: Supervisors Phone Number: (###) ### #### Company Name 2: Company City & State: Position: Dates From: Reason For Leaving: Supervisors Name: Supervisors Phone Number: (###) ### #### LEGAL The Howlin Bird is an equal opportunity employer. Are you a U.S. citizen or do you have a legal right & necessary documents to work in the U.S.? * Yes No Were you ever discharged by any company? * Yes No If Yes, give company(ies) Reason For Discharge? U.S MILITARY SERVICE Branch Of Service: Technical Specialization: Rank Attained: REFERENCES We will contact references that are stated below. Reference 1: * First Name Last Name Company: * Work Phone: * (###) ### #### Years Known: * Reference 2: * First Name Last Name Company: * Work Phone: * (###) ### #### Years Known: * Please Read Carefully I understand that, with my authorization, an investigation may be made whereby information is obtained regarding my character, previous employment general retrobutation, educational background, credit record and/or criminal history, subject to applicable federal, state, and/or local laws. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in immediate dismissal. I understand, also, that I am required to abide by all rules and regulations of The Howlin Bird. * I understand and agree that if employed, the employment will be "AT WILL". That is, either I or The Howlin Bird may end the employment relationship at any time, for any reason, or for no reason. I understand that receipt of this application by The Howlin Bird does not imply employment and that this application and/or any other Howlin Bird documents are not contracts of employment. * The civil rights act of 1964 prohibits dicrimination in employment because of race, color, religion, sex, or national origin. Some states prohibits discrimination because of age. The age discrimination in Employment Act of 1967 prohibits the request of any information on this form. This information will not be used to discriminate against possible employment. We have designed this form to comply with State & Federal Fair Employment Practice Laws prohibiting discrimination on the basis of application's sex or minority status. Questions directly or indirectly reflection such status have been included ONLY where needed to determine a bona fide occupational qualification or for other permissible purposes. Such questions are appropriately noted on the application. * Name: * First Name Last Name Date: * MM DD YYYY Thank you for submiting your application.
